The use of various forms of tubular invasive device is a routine part of today's patient care and keeping them in place is a difficult job. The existing method of using adhesive tape is very primitive in my mind and has its own drawbacks. Not only may it not hold the tubular device in place appropriately, but also it may cause skin reactions, stick to hairs and pull them unwantedly. It is therefore desirable that the use of adhesive be diminished as much as possible.
This problem absorbed my attention and has led to my invention of a new technique that I believe will be very helpful in many cases and locations in holding different forms of tubular devices such as Swan Ganz catheters, arterial lines, arterial sheaths (after coronary angioplasty), Foley catheters, nasogastric tubes, wires of temporary pacemakers, etc. The various devices I introduce use a basic method that may be modified for the particular application. I also introduce two new dilators and a Foley catheter that I believe are much superior to presently available models and will be very helpful in future uses.
The general idea behind this invention is to use wrapping units to hold the tubing and wires and similar materials in place rather than adhesive tapes. These wrapping units are made from synthetic materials and fabrics that are available or can be made easily with some modification of present materials, such as those used in school bags or many disposable medical supplies. They can be cut, shaped, and trimmed to be used in arms, thighs and chest areas. They can be held in place by straps and/or narrow bands of adhesive. The straps are tightened and secured by Velcro.TM. patches, snaps, or adhesive surfaces. The wrap supports and holds a plastic tray that has, or holds plastic moldings with, cradles shaped to accept and hold invasive devices such as those mentioned earlier. These wrapping units keep the invasive devices securely in place by means of flaps, snaps, or plastic covers.
The new types of plastic dilators introduced here are smaller and more compact. They give a definite advantage, are much easier to handle, and can be used with the wrapping units. A special Foley catheter introduced here can also be held by a wrapping unit, making use of such device much easier. A small adaptor is also introduced to allow existing Foley catheters and nasogastric tubes to be used with the wrapping units.
The basic idea of this invention is to make wrapping units for holding various forms of tubular devices in place, which make it easier for patients and the medical staff, and which diminish the need for use of adhesive taping of these devices on skin. These units also diminish the chance of the devices being pulled or displaced easily. For elaboration of the routine problems that occur with the use of adhesive tapes, I feel it will be helpful to mention the following problems that commonly occur with adhesive tape.
The hair on the skin is a problem. Many times it prevents adequate sticking. Furthermore, when the tapes are pulled, they pull the hair causing a very painful reaction. I have witnessed many times when nurses warned patients of such pain and advised them to say "ouch" before removing the tapes. Many times the skin needs to be shaved for heavy taping in the groin area after cardiac catheterization and angioplasty. This is not easy and available every time. It has its own expense and problems, such as occasional infections and bleeding. Some adhesive materials for making the skin stickier may have bad odors and cause skin irritations. One of my own patients exemplified this problem: he had a large area of inflamed skin after the use of this material.
Therefore, it would be wise to diminish and avoid such problems as much as possible. The devices I introduce serve the purpose of holding many of the tubes, wires and catheters in place much easier and better and with much less use of tapes and adhesives.
The basic device, which I call Y. wrap, is made from a strong fabric of synthetic durable or disposable materials, such as used in handbags or some children's school bags. I would like to mention though that although I have not given any specific names for such materials, the state of the art relating to these materials is so advanced that making one for this purpose by experts seems to be very simple and possible. This material will be made in different shapes to fit the particular shapes and anatomy of different areas of the body where the arteries and veins are usually used for different purposes and different types of tubular devices need to be held in place. This wrap holds a plastic tray shaped to match and hold the tubular devices used to invade the body. The plastic tray has a molded shape that allows the particular tubular device to be seated securely on it and be removed when wanted. The molded shape matches the shade of the particular tubular device that is being used. In order for this tray to stay in place and be useful the following methods are used:
1.) In many devices the plastic tray is permanently embedded in the appropriate part of the wrap so as to be held in place securely.
2.) In some models one basic plastic tray "A" will be permanently embedded in the wrap and it will allow the insertion of a previously made molding of plastic "B" to be used. A part "B" will slide or attach to a part "A" by sliding inside it or by having small dents and pieces that will match and holds these parts together.
3.) A tray "A" is covered by a Velcro.TM. patch to accept and stick to a matching Velcro.TM. patch which is stuck to back of a part "B".
4.) A film of adhesive covers the back of part "B" and is protected by a plastic cover. The plastic cover is removed to expose the adhesive which is then stuck to a part "A".
5.) A flap attached to the wrap comes from one side of the tray to go over and cover the molded area that holds the tubular device and is tightened on the other side to hold the tubular device securely in the tray.